| NPI | 1073866380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY 9103) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 019774) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2014-10-02 |